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Detox
This article is about the episode of Season 1. For the treatment process, see Detox (treatment). Detox is a first season episode of House which first aired on February 15, 2005. A teenage boy is admitted when he starts coughing up blood. He gets worse in the hospital, which seems to rule out an environmental cause, or does it? Meanwhile, House tries to prove he isn’t addicted to Vicodin by betting a week without Vicodin against a month without clinic duty, but when he suffers withdrawal symptoms, his team starts to lose confidence in his judgment. Recap A teenage girl convinces her boyfriend to let her take his father's expensive Porsche for a ride. However, during the ride, he starts coughing uncontrollably and coughing up blood. She narrowly avoids one accident, but they get into another. House is waiting for his Vicodin at the pharmacy, but it had been accidentally delivered to the research department. Cameron tells House about the boy - he is still bleeding three weeks after the accident, and he was bleeding before the accident. House figures it is inherited hemolytic anemia. At that point, Cuddy comes by and looks at the file. She starts eliminating diagnoses. House gets interested and takes the case. House gets the team together. The patient will be dead in mere days if they can't figure out what is wrong with his red blood cells. House tells them to ignore environmental causes because if it is one, he will get better just by being in the hospital. However, they can't narrow it down and House orders a battery of tests based on his team's suggestions. House goes back to the pharmacy and gets his Vicodin. Cuddy sees him gulp down the pills and tells him there are other ways of managing pain. She thinks he is addicted, and using Vicodin to get high. She bets him a week off clinic duty that he can't give up narcotics for a week. House bargains up until Cuddy offers no clinic duty for a month, at which point he agrees. Cameron gets a medical history from the patient's father regarding possible drug use. The patient denies doing drugs, but they still have to test his hair. However, he's negative for drugs. The father denies anything in his history could have caused a problem. Cameron suggests other possibilities: an infection, Lupus, cancer - the patient's mother died from pancreatic cancer. They do a biopsy on the patient, which shows it isn't cancer. All the tests show negative, while his hematocrit is still dropping. However, the patient is suddenly getting worse - he starts to lose vision in his left eye. Foreman examines the eye - he has a clot in his retina. They can't treat him with blood thinners or do surgery because he would bleed to death. House asks how a bleeding patient can start having a blood clot. Wilson comes in with the team to keep House company during his Vicodin-free week. House says he isn't going through withdrawal, and urges them back to the case. The patient can't have an infection or cancer, which are usual causes of clots. House is distracted by a beautiful woman doing stretches inside his office. He orders his team to test the heart and intravenously treat for infections. He thinks the woman is a prostitute, but she’s just been hired by Wilson to give House a therapeutic massage. House starts feeling better immediately. The patient isn't eating because he doesn't like the hospital food. He figures the blindness will be permanent because they aren't treating it. The antibiotics aren't working, so House increases the dose. Chase suggests removing vitreous humor from the patient's eye to allow the clot to break up on its own. The procedure goes well and the patient's vision returns. The patient's girlfriend visits, and the patient starts vomitting. They take him to the ICU because his liver is shutting down. House snaps at the patient's father. The team thinks it is because of his pain. His team discuss whether House should be working without his painkillers. House comes in to discuss the liver damage. Cameron points out it can't be the anemia. House suggests hepatitis E. He orders a drug that will make the patient a little worse if he does have it so they can diagnose it. If he doesn't have hepatitis, he probably has Lupus despite the negative ANA test, but if they treat him for Lupus while the problem is hepatitis, they will kill the patient. The team discusses what to do because they can't tell the father the truth about what they are doing. However, Chase backs House up. House is suffering from the lack of Vicodin. He deliberately breaks his hand to get his endorphins working. The father doesn’t want to consent to House's course of treatment. Cameron admits to him that she doesn't think it will work. Wilson treats House, who lies about how he broke his hand, and Wilson catches him in the lie. Wilson figures House did it to overcome the lack of painkillers. Cuddy comes in to confront House about having Cameron lie to the patient's father. House has also refused to treat the patient for Lupus. However, faced with no alternative, the father finally agreed to House's course of treatment. However, before they can start the treatment, the patient starts hallucinating and starts bleeding again (this time from his rectum). The patient then goes into hypovolemic shock. An angiography reveals the patient has severe internal bleeding and a failing liver. Cameron interprets the hallucinations as psychosis and points out that this strongly indicates Lupus, but House replies that the disease is progressing too quickly. Cameron thinks House has screwed up and now the patient needs a new liver. House tells them to put him on the transplant list. Back in his office, House starts vomiting from the withdrawal. Foreman asks what happened to House's hand. Foreman thinks the vomiting is from withdrawal, but House argues it is nausea from pain. He gives House Vicodin to cover his own ass because he figures House can't function without them, and he will kill the patient. They tell the father that it is Lupus and it is too late to treat it. The father is angry when they tell him that his son needs a new liver. However, they will have some trouble finding a transplant as the father isn't compatible. House asks the patient’s father about why the patient said "Jules" during his hallucination. It turns out to be the family's cat, which died about a month ago. House wants to know how the cat died. The girlfriend says the cat was 15 years old so it was old age. House says the patient doesn't have Lupus. House has Foreman and Chase exhume the dead cat. House starts an autopsy on the corpse. The patient's new liver arrives and they prepare the patient for transplant. The patient is put under anesthesia, but House bursts into the operating room and tells Dr. Hourani to stop - it's acute naphthalene toxicity from termites, based on the cat's autopsy. The naphthalene will just poison the new liver too. To get them to stop, House breaks the sterile field of the operating room. House tells the team not to do the transplant. The patient has been losing weight and as the naphthalene has been stored in the patient's fat cells, when the patient lost weight from not eating hospital food, the naphthalene was released. The father finds House and strikes him. House tells the father the cat had the same symptoms as his son. He also tells him that the new liver would not be of any use for his son, since the operation would release more naphthalene into his bloodstream. They start feeding the patient to keep him from burning fat, while Foreman and Chase go look for the termites. They find a large nest in the walls around the patient's room. The patient recovers. House finishes the week without Vicodin, and admits to Wilson that he realized he is a drug addict, but will be going back on the drug. He doesn't think the drug is hurting him; it allows him to do his job and takes away his pain. Wilson clearly disagrees, but doesn't have any compelling arguments. Wilson and Cuddy discuss the result of House's week off Vicodin. Although Cuddy made the bet, it turns out it was Wilson's idea. House lays on his chair listening to music. He opens his eyes to reveal dilated pupils, stoned on Vicodin. His pupils would not have been dilated. They'd have been constricted. Cast * Hugh Laurie as Dr. Gregory House * Lisa Edelstein as Dr. Lisa Cuddy * Omar Epps as Dr. Eric Foreman * Robert Sean Leonard as Dr. James Wilson * Jennifer Morrison as Dr. Allison Cameron * Jesse Spencer as Dr. Robert Chase * Mark Harelik as Mr. Foster * Nicholas D'Agosto as Keith Foster * Amanda Seyfried as Pam * Maurice Godin as Dr. Lawrence Hourani * Marco Pelaez as Marco the Pharmacist * America Olivo as Ingrid * Akiko Morison as Anesthesiologist Major Events * In an attempt to win a bet with Cuddy, House stops using Vicodin. * Mr. Foster is the first person in the series to physically attack House. He won't be the last. * It's later revealed that Wilson was the one responsible for suggesting the bet to Cuddy in the first place. Zebra Factor 10/10 It takes a lot of naphthalene to have this effect, and as such the condition is very rare. Trivia * The title is a double play on the patient needing to rid his body of the toxic naphthalene, and House’s ability to stop using narcotics for a week. * For his performance in this episode Hugh Laurie received a 2005 Emmy nomination for Outstanding Lead Actor in a Drama series. * More about termites on Wikipedia. *Wilson makes a reference to mass murderer Charles Whitman when he says "I wanted to make sure you don't start firing shots from the clock tower." Confused Chronology Cuddy assesses that House is taking twice as much Vicodin now as when she hired him. That seems to indicate House had his infarction before he started working at PPTH. However, other timelines put his disability as happening about five years before the start of the series, and being hired at PPTH eight years before the series started. Or House was a Vicodin-addict before he had a justified reason to take it. Category:Episodes Category:Season 1 Category:Zebra Factor 9